PRECISION-HD2

SEGURIDAD Y TOLERABILIDAD DE WVE-120102 EN PACIENTES CON ENFERMEDAD DE HUNTINGTON

Completado

ACERCA DE

PATROCINADOR

Wave Life Sciences Ltd.

PARTICIPANTES

60

PRECISION-HD2 está probando un nuevo fármaco que reduce selectivamente la proteína mutante de la enfermedad de Huntington, mientras que deja la proteína huntingtina normal relativamente intacta. Para poder identificar el gen con la Huntingtina mutante, utilizan un método único e identifican los llamados SNP. Wave ha identificado dos SNPs diferentes que ayudan a localizar la Huntingtina mutante y, por lo tanto, hay dos estudios (Precision HD 1 y Precision HD 2) con el mismo tratamiento, en los que la única diferencia es el SNP al que se apunta. El objetivo principal es comprender si el fármaco es seguro en un pequeño número de voluntarios, antes de probarlo en una población mayor y recoger pruebas de que el fármaco puede funcionar. Un total de 60 participantes reciben un placebo o diferentes dosis del fármaco activo cada 4 semanas. Tanto el fármaco activo como el placebo se administran mediante inyecciones en la columna vertebral.

Fecha estimada de finalización del estudio: Diciembre de 2020

Edades elegibles para el estudio:

25 años a 65 años (adulto, adulto mayor)

Sexos elegibles para el estudio:

Todos

Acepta voluntarios sanos:

No

Criterios de inclusión

  • Preseleccionados con el SNP objetivo en el mismo alelo que la expansión CAG patogénica
  • Pacientes con capacidad ambulatoria, hombres o mujeres de edad ≥25 – ≤65 años
  • Características clínicas motoras diagnósticas de la EH, definidas mediante la puntuación de confianza diagnóstica de la Escala Unificada de Calificación de la Enfermedad de Huntington (UHDRS) = 4
  • EH manifestada de forma temprana, estadío I o estadío II según las puntuaciones de capacidad funcional total de la UHDRS ≥7 y ≤13

Criterios de exclusión

  • Tumoración o haber recibido tratamiento por una neoplasia maligna, que no sea un carcinoma de células basales o de células escamosas de la piel tratado, en los 5 años anteriores.
  • Haber recibido un medicamento en investigación o un dispositivo implantable en los 3 meses anteriores o un oligonucleótido en investigación en los 6 meses anteriores o 5 ciclos de vida media del oligonucleótido, lo que sea más largo
  • Afección médica clínicamente significativa, síntomas psiquiátricos inestables, abuso de sustancias o embarazo
  • Imposibilidad de someterse a una resonancia magnética cerebral
  • Trastorno óseo, espinal, hemorrágico o de otro tipo que exponga al paciente a un riesgo de lesión o a una punción lumbar fallida

PAÍSES

ACTUALIZACIÓN:

WAVE Life Sciences espera comunicar esta primavera los datos de sus ensayos de fase 1b/2a de PRECISION-HD en curso y los datos disponibles de los estudios OLE (extension sin ocultación) relacionados. El análisis incluirá datos de biomarcadores y de seguridad de todas las cohortes de dosificación hasta la cohorte de 32 mg para PRECISION-HD2, inclusive, y de las cohortes de dosificación completas para PRECISION-HD1 (incluidos todos los participantes de la cohorte de 16 mg). Se espera que estos datos respalden una decisión sobre un posible estudio de fase 3.

Los participantes de los ensayos de fase 1b/2a se han estado inscribiendo en los estudios OLE desde 2020, y la gran mayoría de los pacientes elegibles han sido inscritos. En diciembre de 2020, WAVE presentó una solicitud de ensayo clínico para el WVE-003 (SNP3). Se trata del primer candidato a la EH de WAVE que utiliza sus novedosas modificaciones químicas de la columna vertebral de la PN (phosphoramidate diester) que, según los datos preclínicos, aumentan la potencia, la exposición y la durabilidad de un compuesto. El WVE-003 también está diseñado para dirigirse selectivamente al transcrito del ARNm de la huntingtina mutante, dejando la proteína de tipo salvaje relativamente intacta.

El protocolo también se presentó a la EHDN, y fue aprobado en diciembre de 2020. WAVE espera empezar a dosificar a los participantes en la EH con el SNP3 este año 2022, una vez que las aprobaciones reguladoras y éticas estén en marcha.

DINAMARCA

TRIAL SITE:
University Hospital of Aarhus

Address: Aarhus, Denmark, 8000

CONTACT
Anette T Moller
Tel: Not available

Recruiting

TRIAL SITE: 
Rigshospitalet

Address: Copenhagen, Denmark, DK2100

CONTACT
Lena Hjermind
Tel: Not available

Recruiting

TRIAL SITE:
Odense University Hospital and University of Southern Denmark

Address: Odense, Denmark, 5000

Active, Not Recruiting

FRANCIA

TRIAL SITE:
Hospital Henri Mondor

Address: Créteil, France, 94010

CONTACT
Katia Youssov
Tel: Not available

Recruiting

TRIAL SITE: 
Institut du Cerveau et de la Moelle Epinière

Address: Paris, France, 75646

CONTACT
Alexandra Dürr
Tel: Not available

Recruiting

ALEMANIA

TRIAL SITE:
George-Huntington- Institut GmbH

Address: Münster, Germany, 48149.

CONTACT
Ralf Reilmann
Tel: 49 (0)251 788 788 0 (George-Huntington- Institut)

Recruiting

POLONIA

TRIAL SITE:
Szpital Sw. Wojciecha

Address: Gdańsk, Poland, 80-462

CONTACT
Jaroslaw Slawek
Tel: Not available

Recruiting

TRIAL SITE: 
Instytut Psychiatrii i Neurologii

Address: Warsaw, Poland, 02-957

CONTACT
Grzegorz Witkowski
Tel: Not available

Recruiting

REINO UNIDO

TRIAL SITE:
Royal Devon and Exeter Hospital NHS Trust

Address: Exeter, Devon, United Kingdom, EX2 5DW

CONTACT
Timothy P Harrower
Tel: Not available

Recruiting

TRIAL SITE: 
Queen Elizabeth University Hospital – PPDS

Address: Glasgow, Glasgow City, United Kingdom, G12 0XH

CONTACT
Stuart Richie
Tel: Not available

Recruiting

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SNP-single nucleotide polymorphisms

a single-letter spelling difference in a gene. SNPs, pronounced ‘snips’, are common and most don’t change the function of the gene.

 
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at risk

You do not know if you carry the genetic mutation for HD gene 

 
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TFC-total functional capacity

A standardized rating scale for function in HD, used to assess capacity to work, handle finances, perform domestic chores and self-care tasks.
Scores range from 0 to 13, with higher scores indicating better functional capacity. 

 
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Double-blinded

 means that neither the participant nor the clinical trial doctor can choose or know the group the participant is in until the trial is over. This approach helps to prevent bias.

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Open label

A trial in which the patient and doctor know what drug is being used. Open label trials are susceptible to bias through placebo effects.

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Gene therapy

a technique that aims to treat or prevent diseases by modifying a person’s genes. It involves introducing, removing, or changing genetic material (DNA or RNA) within a patient’s cells.

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UHDRS- Unified Huntington Disease Rating Scale

A standardized neurological examination that aims to provide a uniform assessment of the clinical features of HD

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CAG repeat

The stretch of DNA at the beginning of the HD gene, which contains the sequence CAG repeated many times, and is abnormally long in people who will develop HD

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Wild-type

the opposite of ‘mutant’. Wild-type huntingtin, for example, is the ‘normal’, ‘healthy’ protein

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Tolerabilty

How well a person can handle a treatment without having serious or uncomfortable side effects.

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Striatum

Part of the brain that  coordinates multiple aspects of cognition, including both motor and action planning, decision-making, motivation, reinforcement, and reward system.

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Randomized allocation

A type of allocation strategy in which participants are assigned to the arms of a clinical trial by chance.

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Radioligand

a radioactive substance that binds to a specific target in the body, allowing visualization of that target’s distribution and activity

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Protein

Protein builds, maintains, and replaces the tissues in your body. The building blocks of life.

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Premanifest / Prodromal

Prior to onset or diagnosis of movement symptoms.

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Placebo

A placebo is a dummy medicine containing no active ingredients. The placebo effect is a psychological effect that causes people to feel better even if they’re taking a pill that doesn’t work.

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PK - Pharmacokinetics

The movement of drugs through the body

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PD - Pharmacodynamics

The body’s biological response to drugs

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PET scan

Positron emission tomography which produces detailed 3-dimensional images of the inside of the body.

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Neuron

Brain cells that store and transmit information

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MRI

Magentic resonance imaging: A technique using powerful magnetic fields to produce detailed images and visualizes the structure of organs, tissues, and bones 

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mHTT

Mutant huntingtin protein. The protein produced by the faulty HD gene.

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Manifest

after HD diagnosis, or when symptoms are already showing

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Longitudinal study

A study where each participant is looked at several times over a time period – unlike a cross-sectional study, where each participant is looked at only once

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HTT

one abbreviation for the gene that causes Huntington’s disease. The same gene is also called HD and IT-15

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fMRI

functional MRI:As with MRI, a technique using powerful magnetic fields  but focusing on brain function by measuring and mapping changes in blood flow, revealing which areas of the brain are active during specific tasks or cognitive processes

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CSF - cerebrospinal fluid

A clear fluid produced by the brain, which surrounds and supports the brain and spinal cord.

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Efficacy

A measure of whether a treatment works or not

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ASO(Antisense oligonucleotides)

A type of gene silencing treatment in which specially designed DNA molecules are used to switch off a gene

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Biomarker

a test of any kind – including blood tests, thinking tests and brain scans – that can measure or predict the progression of a disease like HD. Biomarkers may make clinical trials of new drugs quicker and more reliable

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BDNF

Brain-derived neurotrophic factor: a growth factor that may be able to protect neurons in HD.

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Allele

one of the two copies of a gene

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Plasma

Liquid component of the blood.

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Gene

The basic unit of heredity passed from parent to child. Genes are made up of sequences of DNA and are arranged, one after another, at specific locations on chromosomes in the nucleus of cells.

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Phase

Clinical trial phases are different stages of research that assess the safety and effectiveness of a new medical treatment or intervention in humans.

Each phase has a specific goal and involves a different number of participants. Generally, there are 4 phases (I-IV), with Phase I focusing on safety and dosage, Phase II on efficacy and side effects, Phase III on comparing the new treatment with standard treatments, and Phase IV on long-term safety monitoring.